MPT Clinical Examination and Differential Diagnosis 1

Question 1

A positive Spurling test (foraminal compression test) is most indicative of:

Accepted Answer

Cervical nerve root compression

Answer

Spurling test (cervical compression with lateral flexion toward the symptomatic side) reproduces radicular arm pain when a cervical nerve root is compressed, indicating cervical radiculopathy.

Question 2

Which special test is used to assess the integrity of the posterior cruciate ligament (PCL)?

Accepted Answer

Posterior drawer test

Answer

The posterior drawer test assesses PCL integrity by applying a posterior force to the proximal tibia at 90 degrees knee flexion. Excessive posterior tibial translation indicates PCL laxity.

Question 3

A patient presents with progressive weakness and atrophy of intrinsic hand muscles bilaterally, spastic legs, and hyperreflexia. This clinical picture is most consistent with:

Accepted Answer

Cervical myelopathy

Answer

Cervical myelopathy presents with upper extremity LMN signs (atrophy, weakness) combined with lower extremity UMN signs (spasticity, hyperreflexia) due to spinal cord compression at the cervical level.

Question 4

The FABER test (Flexion, ABduction, External Rotation) reproduces groin or hip pain. This finding is most suggestive of:

Accepted Answer

Sacroiliac joint dysfunction or hip joint pathology

Answer

A positive FABER test (groin pain) suggests hip joint pathology (labral tear, FAI, arthritis) or sacroiliac joint dysfunction, depending on pain location (groin vs. posterior SI region).

Question 5

During a sensory examination, the patient cannot distinguish between a sharp and dull stimulus but accurately identifies light touch. This finding indicates dysfunction of which sensory pathway?

Accepted Answer

Spinothalamic tract (anterolateral system)

Answer

Pain and temperature discrimination (and crude touch) are transmitted via the spinothalamic tract. Loss of sharp-dull discrimination with intact light touch indicates anterolateral system dysfunction.

MPT - Master of Physical Therapy Practice Test

MPT - Master of Physical Therapy Practice Test

MPT Clinical Examination and Differential Diagnosis 1